Teen who died playing football had heart abnormality

Autopsy results from the Plymouth County district attorney show that high school football player Joseph Larracey died from a rare and virtually undetectable coronary artery anomaly.

Michael Morton

Autopsy results from the Plymouth County district attorney show that high school football player Joseph Larracey died from a rare and virtually undetectable coronary artery anomaly.

The 16-year-old Holliston Panther was rushed to the hospital Sept. 5 after taking an apparent hit in the chest during a scrimmage with Lakeville's Apponequet Regional High School and later passing out.

Speaking as an outside observer, cardiologist Dr. Daniel Carlucci of Marlborough Hospital and the Heart Center of MetroWest said he suspects the contact acted as a possible trigger of Larracey's condition.

Still, he added, the 16-year-old had a pre-existing condition, one that physical screenings could not have been expected to catch.

"It wasn't their fault," he said of the Apponequet players. "It was unfortunate and unlucky."

Larracey's uncle, Thomas Larracey, has said the 16-year-old was in good health before the scrimmage and had passed a team physical.

Asked about the autopsy results, he said, "I guess it's closure for a lot of people. Just to know what happened to Joe."

He thanked the community for helping his family after their loss.

"I can't tell you how nice people were," he said.

Larracey's condition is known as "anomalous origin" of a coronary artery, said Bridget Norton Middleton, a spokeswoman for Plymouth County District Attorney Timothy Cruz.

Cardiologist Dr. James Alderman, president of the Heart Center of MetroWest, said the condition is a congenital abnormality in which a coronary artery is connected to the wrong portal at the base of the aorta and subsequently needs to use a different route to supply blood to the heart.

Some of the alternative routes cause no ill effect, but a coronary artery ending up in the "valley" between the aorta and the pulmonary artery can get squeezed or go into spasms, restricting vital blood supply, he said.

Sudden death from an abnormal heart rhythm can result.

While data is limited, Alderman said research has found that an estimated 1 in 200,000 young athletes die suddenly, with the coronary artery condition responsible for nearly 14 percent of the cases.

"Everyone is shaken up when an event like this occurs," he said. "These events are shocking, especially because of their random nature."

Alderman and other cardiologists said a condition like Larracey's frequently does not show up in stress tests or electrocardiograms, with those who have it often don't experience symptoms until it's too late.

"It's frustrating," said Dr. Margot Putukian, a Sudbury native and the director of athletic medicine at Princeton University, noting that only 50 percent of people with the condition experience symptoms, usually while exercising. "You hate to miss something like that."

Carlucci agreed.

"It's next to impossible to pick that one up," he said, referring to screening for the condition.

If caught, however, the condition can be fixed with a bypass or by surgically re-attaching the artery to the proper portal. Putukian advised athletes to immediately report dizziness or chest pain experienced while exercising.

Doctors typically screen student-athletes by following American Heart Association guidelines, asking their patients about their experiences and family history and testing for things like blood pressure, pulse and potential heart murmurs, Putukian said.

While every student-athlete could also theoretically receive stress tests and electrocardiograms, Alderman said it would require a tremendous amount of resources and would not lead to every arterial condition being detected.

"That's the philosophical question," he said.

Although some private companies offer a full cardiac workup for athletes with parents willing to pay out of pocket, Carlucci said the American Heart Association instead recommends that defibrillators and trained medical staff be available at games.

Amid the public release of the autopsy, Superintendent Bradford Jackson said the school community continues to grieve Larracey's loss, with one support group for adults and another for students.